Tetrahydrocannabinol vape-associated cannabis arteritis in a patient with minimal tobacco exposure

Area of Science:

• Vascular Medicine
• Toxicology
• Rheumatology

Background:

• Thromboangiitis obliterans (TAO) is an inflammatory vasculopathy strongly linked to tobacco use, primarily affecting young men.
• Cannabis arteritis is considered a potential counterpart, but its independent role is debated due to frequent co-use of tobacco.
• Understanding the distinct etiological factors in vascular diseases is crucial for accurate diagnosis and treatment.

Observation:

• A 31-year-old male presented with severe claudication, a symptom of peripheral artery disease.
• His symptoms began concurrently with vaping high-potency tetrahydrocannabinol (THC).
• Crucially, the patient had a minimal history of tobacco exposure (<1 pack-year).

Findings:

• The patient experienced significant improvement in claudication after discontinuing cannabis use for 4 weeks.
• This clinical course suggests a direct link between cannabis consumption and the development of arteritis.
• The absence of significant tobacco use challenges the notion that cannabis arteritis is solely a variant of TAO driven by tobacco.

Implications:

• This case suggests that cannabis, particularly high-potency THC products, may independently cause a thromboangiitis obliterans-like arteritis.
• It underscores the need for clinicians to consider cannabis use as a potential etiological factor in young patients presenting with peripheral vascular disease.
• Further research is warranted to elucidate the mechanisms by which cannabis induces vascular inflammation and occlusion.